联合包皮及阴囊带蒂皮瓣修复阴囊型尿道下裂

The combined use of pedicle flap from both prepuce and scrotum for the treatment of scrotal hypospadias

目的 总结带蒂岛状包皮瓣尿道成形术 (Duckett术 )加阴囊中隔带蒂皮瓣翻转尿道成形术 (中隔皮瓣术 )治疗阴囊型尿道下裂的体会。 方法 对 19例年龄 2～ 12岁 ,尿道缺损长度 5 .0～ 9.0cm的严重阴囊型尿道下裂患儿应用Duckett包皮瓣成形加阴囊中隔皮瓣成形手术方法修复 ,探讨手术应用、并发症预防及尿流改道方法的选择。 结果 19例随访 6个月～ 4年 ,17例获一期治愈 ,2例并发尿瘘 ,无尿道狭窄并发症。 结论 联合手术方法治疗阴囊型尿道下裂效果满意 ,并发症少 ,双管法尿液引流充分 。

Objective To present the experience of repairing advanced scrotal hypospadias with the combined use of tubed transverse preputial island flap (Duckett) and inversed scrotal raphe flap urethroplasty. Methods 19 cases were operated on with repairing distal urethral tube by Duckett preputial island flap and scrotal raphe flap urethroplasty with suturing together the adjoining ends of the two tubes on an oblique plane.The age of the patients ranged from 2 to 12 years. The length of urethroplasty was 5～9 cm. Results All the cases were followed up for 6 months to 4 years. 17 cases recovered fully on one stage operation. 2 were complicated by urethral fistula. Conclusions The results are satisfactory.The use of a casing tube is reasonable and nontraumatic.